Tag - dengue fever

BNH Hospital is one of Thailand’s leading hospitals, dealing with the health isses of visitors and locals for over a century. If anyone is in a position to give good advice on health issues for visitors to Thailand, they are. Whether you simply need to know how to prepare for your trip, your concerns are current health scares, or you want to know how to benefit from the excellent medical services available to you while you are in Thailand, drop them a message and they will do there best to answer. All questions and answers will be shown on this page. Simply put your query in the form below and press send. If you have news on health issues, or simply want to pass on some good advice of your own, let us know what you have to say using the same form. Use the form below to have you health queries answered:

Frequently Asked Questions answered here:

Yelena writes: “Hello, I will be traveling to Thailand Summer 2008 for three weeks. I think for the most part I will stay in the major cities, but i would also like to see the jungle. I know that i need Hepetitis A and Typhoid vacination. What about Japanese encephalitis? Thank you.”

BNH Hospital answers: “Thank you for your inquiry. Japanese encephalitis is an important when you will be staying in Northern of Thailand for long period of time (more than 1 month). However, if you aren’t to stay for long period of time you should protect of yourself by During the hours of darkness wear long trousers (pants) and long sleeve shirts. Using mosquito repellent. Staying in air conditioning room because this disease spread by mosquito. The illness is most prevalent in rural areas especially near pig farms. If you have any father inquiries, please, do not hesitate to let me know.”

Nigel Andrews: Hi, I’m traveling to Thailand for ten days in two weeks time I’m spending 5 days in Phuket and 5 days Bangkok is it to late for jabs but what jabs do I need? Many Thanks Nigel.

BNH Hospital answers: Thank you for your inquiry. I would like to explain you about vaccinations you should get when you stay in Thailand. However, you should get before you come to Thailand 7-10 days. Are you traveling in Thailand now? So, it is too late. Therefore, I explain to you for next time. 1. You should receive Hepatitis A, Typhoid because these diseases transmission is primarily via person to person, generally through fecal contaminated and oral ingestion. The virus can be spread through contaminated food (such as uncooked fruits and vegetables), shellfish, ice and water. 2. If you like tattooing you should receive Hepatitis B also because this disease exposure to contaminated blood and blood products; use of contaminated needles, razors, dental and medical equipment, tattooing and body-piercing devices; and sexual contact with infected individuals. 3. Tetanus transmission typically occurs via contamination of wounds, burns and punctures so if you can protect yourself from these, you don’t need tetanus vaccine. 4. Most of Thailand is malaria free except near the border areas of Burma, Cambodia, Laos, Vietnam, national forest and Koh Chang. There is no vaccine available for malaria yet. Also malaria prophylaxis medicine is not 100 % protective against malaria. Currently dengue fever is a problem (there is not medicine or vaccine for dengue.) Best are repellents, long sleeve clothing, and sleep in netted areas. If you would like to take medicine, Malarone would be the best but is not available in Thailand and South East Asia. It would be the best if you can buy it from home.

Christine Carver writes: “Dear Sir/madam, my friend has visited Chiang Mai, Krabi and Phi Phi, leaving Thailand on 14/2/07. Over the last 10 days she has had high temperatures, headaches, nausea and general aches and pains. The nausea has settled but she now has a slight cough. she has been generally very weak. There is no rash. Could you advise us if she is at risk of any tropial diseases from visiting these places in Thailand? We wondered about malaria or dengue fever. is there anything else we should be concerned about? We are very grateful for any advice you can give. Thank you so much.”

BNH Hospital answers: “Dear Ms. Carver, In this case it might be a viral infection. We would recommend you to see your doctor and have blood tests to confirm.

Finn Hjelmstrom writes: “We are going to stay for approx 3 weeks at the eastern part of Koh Chang in Jan/Feb next year. We do not know whether there is air con or not. Will this demand for any malaria prevention? Will our further trip to Cambodia (Sihanoukville and Phnom Penh) increase this demand? Thanks for your speedy reply Finn Hjelmstrom”

BNH Hospital answers: “Thank you for your inquiry. We recommend travelers to take anti malaria when they have to stay in forest or risk area for long periods of time (more than 1 month). Anyway anti malaria for Koh Chang and Cambodia is Doxycycline may cause photosensitivity, an increased frequency of candida vaginitis, nausea, vomiting. You should take 1 tablet one day before you leave your country and continue1 tablet daily during your stay in the risk area. On your returning home you should complete another four weeks course of tablet. So if you arenÃ‚Â’t staying in forest or risk area for long periods of time, you should protect yourself from mosquito by wearing long trousers (pants) and long sleeve shirts, and using mosquito repellent.”

Bob writes: “We are travelling to thailand with our 22 month old daughter and plan to stay for two months. we would prefer to avoid malaria risk areas so our daughter need not take any malaria pills. can you tell us whether any of the following possible travel destinations should be avoided: khao lak, koh lanta, kho phangan, kho tao, in the south and chang mai and pai, in the north… do you have any other recommondations for travelling with baby, other than sunscreen, mosquito nets and – repellent…?? thank you very much for having this forum available…”

BNH Hospital answers: “Thank you for your inquiry. We send file about risk area of malaria in Thailand for you. (See Malaria map in Thailand) I think this map can help you avoid malaria risk areas. We recommend travelers to take anti malaria when they have to stay in forest or risk area for long periods of time.”

A visitor writes: “My daughter is visiting Koh Phi Phi Island and was bitten by a monkey. Does she really need the vaccine? Has there been rabies on that island?”

BNH Hospital answers: Vaccinations are available at every hospital in Thailand. There is no case of mokey bite but last year there was a dog found with rabies on the Island. To be safe she should take Rabbie vaccine and Tetanus as the monkey is wild monkey, you can never be sure if it has rabie or not. The wound should be wash throughly and make sure that it is clean. If the wound is very bad, or the monkey that bite your daughter is suspected to have rabbie, she should take Immunogloblin which is stronger than rabie too. The contact number is Phi Phi Hospital contact number is 03-501-7228 I tried to contact them but no one pick up the phone. They should have Rabie vaccines at ER. (Embedded image moved to file: pic22704.jpg) Another option is Krabi Hospital (2hrs from Phi Phi Island by boat) 075-611212 I have checked with Krabi Hospital. They have all the vaccines available at ER.

Samantha Edelsten writes: “I purchased a course of Malarone tablets(42) in the UK prior to travelling to SE Asia but have now decided to stay longer but need to purchase some more tablets. Is there anywhere in Bangkok I can do this or will I need to visit a doctor to get a prescription?”

BNH Hospital answers: Thank you for your inquiry. Malarone tablets is not available in Thailand. We available doxycycline (anti malaria tablet for SE Asia) may cause photosensitivity, an increased frequency of candida vaginitis, nausea, vomiting. You should take 1 tablet one day before you leave your country and continue 1 tablet daily during your stay in the risk area. On your returning home you should complete another four weeks course of tablet. I think if you aren’t staying in forest or risk area for long periods of time, you should protect yourself from mosquito by wearing long trousers (plants) and long sleeve shirts, and using mosquito repellent.

Shari Lemieux writes: “Hello We will be travelling to Thailand from Canada on Dec.15th/ 2006 to Jan.2nd /2007. Probably to Bangkok and then down south and back up again to Bangkok (Phuket, Chang mai, river Kwai & Phi Phi). I am a nurse and I already have had my Hepatitis B vaccination and also my Tetanus. Should It be wise for me to also receive the HepatitisA and Typhoid vaccinations? Would you recommend the TWINRIX series of shots for me? IS there any problems in any area of Thailand that we should know about before visiting? Thanks for your help in advance.

BNH Hospital answers: “Yes, we always recommend vaccination against hepatitis A and Typhoid for traveller before come to Thailand. Twinrix is a vaccine that protection from Hepatitis A and B thus if you already have had hepatitis B vaccine, you should only receive Havrix (1440) vaccine for Hepatitis A.”

Simona: “Do I need a prescription to buy Doxycicline from a chemist in Thailand? Will I find it in Koh Chang?”

BNH Hospital answers: “Yes, you will find it in Koh Chang. We recommend travelers to take doxycycline when they have to stay in forest or risk area for long periods of time because doxycycline may cause photosensitivity, an increased frequency fo candida vaginitis, nausea, vomiting. You should take 1 tablet the day before you leave your country and 1 tablet each day of your stay, if in a risk area. On your return home you should complete the course of tablets by taking one each day for a month.

Victoria Smith writes: “I will be travelling to Thailand in Dec/ Jan. I will be visiting Chaing Mai, Phuket, Khao Sok, Koh Lanta & Bangkok. Will I need to take Malaria tablets? What other precautions can I take other than wearing long sleeves to ensure I do not get bitten??”

BNH Hospital answers: “Thank you for your enquiry. Regarding malaria tablet, it’s depend on how long is your trip? And where will you stay? If you stay in a hotel, no problem but if you do camping in jungle you should to take anti Malaria tablet and bring mosquitoes repellent with you.”

Rik writes: “Hello. I am travelling in November 206, to Bangkok, Phuket, Koh Phi-Phi Don and Koh Samui. Please advise if I should take malaria tablets or any other vaccines.”

BNH Hospital answers: “You should have HepatitisA and Typhoid vaccinations against diseases from food and water but not necessary for malaria tablet in Samui and Phuket because they are not risk areas.”

Adam writes: “Myself and my girlfriend are travelling to Thailand in November for 3 weeks, we will be in Bangkok for 3 nights, Phuket for 4 nights, Krabi for 4 nights, Koh Samui for 6 nights and then back to Bangkok for 2 nights before flying home! Am I correct in thinking that we will need vacinations against HEP A and TYPHOID? Do we need to take any other precations apart being careful what we eat? Any help would be greatly appreciated!”

BNH Hospital answers: “Yes, you should have vaccinations against HepatitisA and Typhoid. The places you are staying are not malaria risk area so using mosquito repellents, wearing long sleeve shirts and stay in air-conditioned or netted aread should be sufficient.”

Tracy Brown writes: “I am going to Bangkok and Pattaya for 11 days do I need to take malaria tablets?”

BNH Hospital answers: “Thank you very much for your inquiry. Regarding on your visit to Bangkok and Pattaya, both areas are not risk area. Wearing long sleeve shirt and apply the anti-mosquito lotions to prevent mosquito bite would be sufficient. Hepatitis A and Typhoid vaccination is recommended on your visit as infection of these can be through food and water.”

Laura Ient writes: “My daughter age 16 has just returned from Thailand. She tells me that during one or two days (she has not told me exactly!) of her trekking phase she did not take her malaria tablets. Please can you advise what the likely risk is. She has had lots of bites to her legs and ankles. Also should she take more malaria tablets for longer given the laps?”

BNH Hospital answers: “Regarding the mosquito bites that your daughter has, she need not take any malaria tablet as it is only use for prevention. Observation is recommended, she should seek doctor’s consultant in case she has any symptoms like fever or severe headache.”

Maxine writes: “Family & friends (20) from New Zealand are coming to Thailand for my sons wedding in Burirum. We will be spending 4 days in bangkok & 5 days in Burirum and the day of the wedding in a village 45 minutes from Burirum. My questions are; 1 Is Burirum a Malarious Area. 2 For such a short stay is Typhoid & Rabies prevention required I have recommended to family & friends that they should have Hep A&B, Tetanus/diptheria.”

BNH Hospital answers: “Thank you for your letter. Burirum is not a risk area. The vaccinations needed vary according to the length of time you are going to stay and the place where you are going to visit. For a visit less than two weeks Hepatitis A and Typhoid are required. JE Rabies and Tetanus/diphtheria are needed if you are staying over 3 months. The vaccination should be taken 2 weeks before the trip. However for a very short stay, paying more attention on food and drinks by not eating food from roadside and drink only from clean water bottles should be sufficient.”

Camilla writes: “I am travelling to Thailand at the beginning of November for two weeks, i will be visiting Phuket, Phi, Phi and Krabi after flying into Bangkok – wondered whether there were any specific precautions to take for that area – eg vaccinations before hand.”

BNH Hospital answers: “Camilla. Vaccinations recommended for a two and a half weeks visit are HepatitisA and Typhoid which can be infected through food and water.The vaccinations should be taken 2 weeks before the trip.If you are concious about malaria, wearing long sleeve shirt and apply the anti-mosquito lotions to prevent mosquito bite would be sufficient.”

Kevin writes: Hello I need a Hep A boost before travelling around asia and also to take malaria tablets. Is it too late to do this on arrival to Bangkok or should i need to do it before i leave home.

BNH Hospital answers: “We would recommend you to take the vaccine at least 2 weeks before the trip for the vaccine to be fully function.”

Amanda writes: “We are travelling to thailand for 6 weeks what vaccinations do we really need? do we need to get malaria tablets?

BNH Hospital answers: “Ms. Sheridan, Thank you for your letter. The vaccinations needed will vary according to the lenght of time you stay and the place you are going to visit. For a six week visit in Bangkok the vaccinations needed are Hepatitis A and typhoid. If you plan to visit the jungle or staying over 3 months, it would be necessary to take JE, Rabies and Tetatus/dihtheria too.The vaccinations should be taken at least two weeks before the visit. Bangkok is not a Malaria risk area. If you plan to stay only in the city, try to avoid mosquito bites by wearing long sleeve shirts and apply anti mosquito lotion would be sufficient. Again if you are going to visit the jungle or island we would recommend you to take malaria tablets. Malarone would be the best choice with the least side effect. You should purchase it from you country as it is not available here in Thailand and SEA. Doxycycline is cheaper and available here but may cause some side effects such asphosensitivity, Nausia/vomitting and increase candida vaginitis, thought it does not happen to everyone. For Malarone you have to take one week before the trip and one month after the trip. For doxycycline, 1 day before the trip and one month after the trip.”

Linda writes: “I am going to Bangkok for one week at the end of October. Do I need any injections, I am staying at the Amari Watergate Hotel,also what about malaria tablets. Thankyou.”

BNH Hospital answers: “For a business visit of one week in Bangkok vaccinations is not required. Some recommendation would be to pay extra attention to food and drink. Try to avoid street side food and drink water only from clean clear bottles. Regarding malaria tablet, Bangkok is not a risk area. Try to avoid mosquito bite by waring long sleeve shirt and apply anti-mosquito lotion would be sufficient as Malaria tablets may cause some side effects.”

Ms Collard writes: “Can we get our travel vaccinations while we are in thailand. as we are spending 6 months in thailand before we do a round the world trip? Where can we get them done (we will be staying near mbk) and how much?”

BNH Hospital answers: “Dear Ms. Collard, Thank you for your letter. We would recommend you to take the vaccinations before coming to Thailand as some vaccinations needs to be done two weeks before the trip. The list of the vaccinations needed for a six months stay here are as followed:- 1. Influenza 2. Hepatitis A 3. Typhoid 4. JE 5. Rabies 6. Tetanus/diphtheria

Regarding the round the world trip, vaccination required will be according to your destination and length of stay at the particular place. You can get your travel vaccinationation here in Thailand. The Internal Travel Medicine Clinic (ITMC) Located at the BNH Hospital Hospital can provide you the service. It is not far from MBK and it has the update of any disburst and news directly from WHO weekly. For any further information please contact the International Travel Medicine Clinic (ITMC) BNH Hospital Hospital Tel: 02-686-2700 ext 1165.

Darren writes: “Hi there can you confirm if Koh Chang is Malaria free or not .Thank you for your help?”

BNH Hospital answers: “Koh Chang is still a Malaria Risk area. For a short stay we suggest wearing long sleeve shirt and apply anti-mosquito lotion and try to avoid mosquito bite would be sufficient. If you are to stay over 15 days, you should take some malaria tablet. Malarone is the best choice but not available here in Thailand and SEA. We suggest Doxycycline, hospitals will have them in stock. Some caution is that it may have some side effect of phosensitivity,Nausia/vomitting and increase candida vaginitis, thought it does not happen to everyone. For Malarone you have to take one week before the trip and one month after the trip. For doxycycline, 1 day before the trip and one month after the trip.”

Marie writes: “Dear Sirs/Dr I will be in Bangkok from 17th till 24th of this month, I will be staying in the bangkok area and will be staying at night in a hotel. During the day I will visit the city a bit. I would like to know if I need to take some malaria tablets. If Yes, could you please indicate which ones ( I beleive there are different ones for different degrees of resistance of the virus). Do I need to cover my skin with mosquitos repulsive lotion everyday? I beleive there will be 80% humidity so the lotion might go away quickly! thanks a lot for a precise answer. yours sincerely, Marie MORELLI”

BNH Hospital answers: “Regarding your visit here in Thailand, Bangkok is not a Malaria Risk area, for your length of visit we do not recomment you to take any Malaria tablets. We suggest that wearing long sleeve shirt and applying mosquito repulsive lotion would be sufficient. (Mosquito repulsive lotion normally last around six hours. For your information, there are a few types of Malaria tablets available. The best option would be Malarone which is not available here in Thailand and South East Asia, you should try to buy it from your country as It has the least side effect. The best available here are doxycycline, it is cheaper but may cause side effects such as phosensitivity, Nausia/vomitting and increase candida vaginitis, thought it does not happen to everyone. For Malarone you have to take one week before the trip and one month after the trip. For doxycycline, 1 day before the trip and one month after the trip.”

Sarah writes: “Hello I am travelling to thailand at the beginning of November staying 3 nights in bangkok and 8 nights in Koh Samui could you please tell me do i need any vaccinations before i go and if so when should i take them.”

BNH Hospital answers: “Dear Ms. Brooks, We are very sorry for the delay in reply. Vaccination required are .Hepatitis A and Typhoid, they should be taken two weeks before the trip. For your information Samui is still a malaria risk area, we suggest that you should wear long sleeve shirt and apply anti-mosquito lotions.”

Marcus Mehlkop writes: “I will be in Thailand for one week and plan to visit Koh Samet. Is Koh Samet a malaria risk area? Do I need to take anti malaria tabletts? Is it a good advise to buy malaria tabletts for standby in Germany? What tabletts should I buy for standby in Germany? Many Thanks

BNH Hospital answers: “Regarding our question, yes Koh Samet is a risk area. However if you are well protected from mosquito bite by wearing long sleve shirt and apply anti mosquito lotion would be another option than having malaria tablets. If you would like to take malaria tablet there are a few choices, buying malarone from your country would be the best choice as it is effective and has the least side effect and is not availabe in South East Asia. Doxycycline is available here, it is cheaper but may cause side effects such as phosensitivity,Nausia/vomitting and increase candida vaginitis, thought it does not happen to everyone.”

Michelle McCarthy writes: “Is it possible to buy Doxycycline for anti malaria over the counter at a chemist in Bangkok?”

BNH Hospital answers: “Michelle, Thank you very much for your enquiry. Doxycycline is not available at the chemist counter. At Khaosanroad most of them provide Metfloquin which is not so effective as there are resistant. However most of the hospital in Bangkok do have them in stock.”

Denise Hoey writes: “I will be in Thailand for two and a half weeks and plan to visit Bangkok, the River Kwai, Chiang Mai (including trekking to hill tribes), Ko Samui and some of the National parks (including Khao Yai and Khao Sok). What vaccinations or protection do you advise for these areas? many thanks.”

BNH Hospital answers: There are a few choices available for the anti-malaria tablets. Malarone is the best choice with the least side effect also the most expensive,( it is not available in Thailand and South East Asia.) Doxycycline is cheaper but some side effects of medicine could be make you phosensitivity,Nausia/vomitting and increase candida vaginitis although not everyone will get this side effects. We would suggest you to buy Malarone from your country. For Malarone you have to take one week before the trip and one month after the trip. For doxycycline, 1 day before the trip and one month after the trip. Other vaccinations recommended for a two and a half weeks visit are Hepatitis A and Typhoid which can be infected through food and water. If you have any further queires please don not hesitate to contact me. I hope you have an enjoyable holiday here in Thailand. Currently there are flood in some area of the North I suggest you should check it out before coming.”

Coco writes: “What’s happening with the bird flu? is it dangerous to eat eggs or chicken in Thailand?”

BNH Hospital answers: “Thank you very much for your inquiry. Regarding the bird flu I have checked with the BNH Hospital Hospital ITMC (International Travel Medicine Clinic) in Thailand so for there were no recent report, the latest incident report was 2 months ago in Karnjanaburi province. It is safe to eat eggs and chicken in Thailand provided that they are well cooked.”

Heidi Henderson writes: “I am travelling to Thailand from Canada. I am 4 months pregnant and healthy. I want to be careful and ensure I have the vaccinations that are possible/necessary in my condition. I plan to travel north and to the islands. Any recommendations on what I should be doing/avoiding in terms of locations/food?”

BNH Hospital answers: “Thank you very much for your inquiry. We do not recommend vaccinations as it may have side effect with the baby. If you already have Hep B vaccination that would be good enough. Recommendations would be additional attention on food and water, make sure that the food is well cooked and drink clean water (available in bottles).”